A pessary is a non-surgical treatment for prolapse of the vagina and uterus.
A pessary is a device used to correct vaginal and uterine prolapses and urinary incontinence in women. These conditions are more likely to occur in women past the age of menopause when tissues become thin and weakened. The alternative to a pessary is surgical repair, a much more complex and expensive remedy both for the patient and the physician. In order to receive reimbursement from insurance carriers and Medicare, medical providers must use the correct medical billing codes.
Instructions
1. Bill for diagnosis with codes 618.1 and 618.0x. Add a fifth digit depending on the exact nature of the diagnosis, the difference between uterine and vaginal prolapse as defined by the office billing codes. This billing generally includes fitting various size pessaries and issuing a prescription for the patient to fill. Bill for the fitting of a pessary for a new patient with CPT code 99213 or 99215. For an established patient, use code 99293 or 99295.
2. Bill for evaluation and management of pessary treatment along with bill for yearly examination by adding 57160 plus 25. The modifier 25 indicates separate evaluation and management service on the same date and time of the regular examination and would include the placement of the pessary as well as instructions for the patient.
3. Bill for follow-up visits or treatment with codes 99213 or 99214 depending on the complexity of the visit. Use 99213 plus 25 for assessment of atrophism. Bill for irrigation of the pessary with code 57150 plus 25.
